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目的:比较系统性红斑狼疮患者(systemic lupus erythematosus,SLE)和正常对照两组间的血清抗核小体抗体家族分子的表达水平;分析抗核小体抗体家族分子与SLE患者疾病活动度之间的关系,并探讨血清抗核小体抗体家族分子与患者器官/系统损害的关联是否涉及细胞凋亡。方法:病例来自两所三甲医院住院SLE患者,以健康志愿者为对照组;运用流式细胞术,采用连接素V和碘化丙啶双染法检测研究对象的外周血单个核细胞(peripheral blood mononuclear cells,PBMCs)的早期凋亡率;以双抗夹心酶联免疫吸附实验测定研究对象外周血抗核小体抗体家族分子的表达水平。结果:SLE患者的血清抗核小体抗体、抗dsDNA抗体、抗组蛋白抗体阳性率分别为68.42%、53.95%、44.74%,而在正常对照组血清抗核小体抗体家族分子均为阴性。SLE非活动组(n=23)和活动组(n=53)患者的血清抗核小体抗体表达水平(分别为81.697±86.256 IU/ml、101.957±97.431 IU/ml)、抗dsDNA抗体(分别为266.881±366.684 IU/ml、286.483±279.298 IU/ml)、抗组蛋白抗体(分别为45.421±58.262 IU/ml、64.257±69.976 IU/ml)均高于正常对照组(n=69,分别为10.106±0.5348 IU/ml、20.034±12.075 IU/ml、9.290±1.281 IU/ml),三组间差异均有统计学意义(F=29.414,P=0.000;F=24.872,P=0.000;F=20.147,P=0.000)。但SLE患者非活动组和活动组的3种血清抗核小体抗体家族分子浓度差异均无统计学意义。仅发现抗组蛋白抗体与SLEDAI之间呈正相关(r=0.251,t=2.234,P=0.029)。多重线性回归分析结果表明,抗核小体抗体水平在临床上可作为SLE患者疾病活动度的监测参考指标;而对于活动期SLE患者,抗dsDNA抗体可较好地反映疾病活动度。结论:SLE患者血清抗核小体抗体家族分子的表达水平增加,且与患者的PBMCs的早期凋亡率呈正相关。抗核小体抗体水平在临床上可作为SLE患者疾病活动度的监测参考指标;而对于活动期SLE患者,抗dsD-NA抗体可较好地反映疾病活动度。
OBJECTIVE: To compare the expression levels of anti-nucleosome antibody family members in patients with systemic lupus erythematosus (SLE) and normal controls, and to analyze the relationship between the activity of anti-nucleosome antibody family members and SLE patients And to investigate whether the association of serum anti-nucleosome antibody family molecules with organ / system damage in patients is related to apoptosis. Methods: The cases were from hospitalized SLE patients in two top-three hospitals and healthy volunteers as control group. Flow cytometry was used to detect peripheral blood mononuclear cells (peripheral blood mononuclear cells (PBMCs). The expression of anti-nucleosome antibody family members in the peripheral blood was measured by double-antibody sandwich enzyme-linked immunosorbent assay. Results: The positive rates of anti-nucleosome antibody, anti-dsDNA antibody and anti-histone antibody in serum of SLE patients were 68.42%, 53.95% and 44.74%, respectively, while those in the normal control group were all negative. Serum anti-nucleosome antibody expression levels in patients with SLE inactive (n = 23) and active (n = 53) were 81.697 ± 86.256 IU / ml and 101.957 ± 97.431 IU / ml, respectively (266.881 ± 366.684 IU / ml, 286.483 ± 279.298 IU / ml) and anti-histone antibodies (45.421 ± 58.262 IU / ml and 64.257 ± 69.976 IU / ml, respectively) were higher than those of the normal control group 10.106 ± 0.5348 IU / ml, 20.034 ± 12.075 IU / ml and 9.290 ± 1.281 IU / ml, respectively. There were significant differences among the three groups (F = 29.414, P = 0.000; F = 24.872, P = 20.147, P = 0.000). However, there was no significant difference in the concentration of anti-nucleosome antibodies among the three serums in inactive and active SLE patients. Only anti-histone antibodies were found to be positively correlated with SLEDAI (r = 0.251, t = 2.234, P = 0.029). Multiple linear regression analysis showed that anti-nucleosome antibody levels could be used as a reference value for monitoring disease activity in patients with SLE. For anti-SLE patients, anti-dsDNA antibodies could reflect disease activity. CONCLUSION: The expression of anti-nucleosome antibody family members in SLE patients is increased, which is positively correlated with the early apoptosis rate of PBMCs. Anti-nucleosome antibody levels in clinical SLE patients can be used as a monitoring indicator of disease activity; and for active SLE patients, anti-dsD-NA antibodies can better reflect the disease activity.